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APPLICATION FOR PLUMBING PE66RMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DPJff
BDiLDING /
JOHN A. LAMBIE, COUNTY ENGINEER ADORERS 6 C!T l '7"'�
,cl?-y8 WILLIAM A. JENSEN, SUPT oP Bm LDING
LOCALITY
FOR APPLICANT TO FILL IN CH�ST.
NUMBER FIXTURE OR ITEM OWNER
WATER CLOSET MAD,
J ADDRESS
BATH TUR
CRY TEL NO.
SHOWER
LAVATORY CONTRACTOR Alert Plumbing & Haati nC,
RINE ADDRESS13933 So . Crenshaw
DISHWASHER cm Hawthorne nm- NO- OS 93691
LAUNDRY TDB e c s RATION NO. STATE193617 C-36 coTY
/ CLOTHES WASHERDIC8�B,1G/T�N(q� GRDu9 BEDBBY/
WATER HEATER -� / L-' �> NE 7;&_
&_ d
I INDUSTRIAL O
GAS SYSTEM WASTE APPROVAL u
INSPECTION RECORD 99
O
I-
W
D.
Z
® $1.00 PER REM
j O OR FIXTURE $ /5 APPROVALS JDATE �INSPECTOR'S
SSIG
NATURE
PERMIT $ 2 100 UNDER SLAB WORKYl��yyI lJ�✓ !/1-. Lt. YJ
ROUGH PLUMBING CI �I. LA`s :TfA
TOTAL FEE GAS PIPING I J�Nd'�" c fF�"
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION /
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY GAS VENT ' /I
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING.
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES 1 1 1 �1 /q{ / hl/A
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT 1 AM T LEGAL OWNER OF THE ABOVE _ ( y
DESCRIBED RESIDENTIAL PRO R UTILITY CO. NOTIFIED
SIGNATURE
OF PERMITTER FINAL A I `J �p v/MI//
CK.VALIDATION ROBERT BET A. WOOD //I
M.0. CASH SUPERVISING MECHANICAL ENG'R
L r.o 2 3 7 iiAR 3 0 5 D 12.0 C :r